供血者血中3种支原体（Uu、Mh、Mpn）核酸检测研究

目的：探讨供血者血中是否存在解脲脲原体（Uu）、人型支原体（Mh）、肺炎支原体（Mpn）等致病性支原体。方法：应用nested PCR和DNA测序等分子检测技术检测血中Uu、Mh、Mpn等3种支原体核酸。结果：1．将Uu、Mh、Mpn3种支原体培养液与血浆、血清按不同稀释度制备成模拟标本,经nPCR检测均获成功。2．105例供血者（98例无偿献血者,7例卖血者）中检出无偿献血者1例Uu核酸阳性者（女,18岁）;检出卖血者1例Mh核酸阳性者（男,32岁）;无检出Mpn核酸阳性者。3．阳性者的Uu nPCR和Mh nPCR产物经全自动DNA测序与Uu、Mh典型株序列完全一致。结论：我国供血者血中携带有Uu和Mh。鉴于Uu、Mh感染孕妇或新生儿可导致严重后果,而孕妇和新生儿又是主要的受血群体,因此应引起血站和围产医学、优生工作者的高度重视。     

儿童肺炎肺炎支原体及肺炎衣原体联合基因诊断研究

目的：探讨我国肺炎儿童中肺炎支原体（Mycoplasma pneumoniae,Mpn）和肺炎衣原体（Chlamydia pneumoniae,Cpn）的感染状况和Mpn和Cpn合并感染状况。方法：收集80例健康儿童和134例肺炎儿童之咽拭子标本,应用套式PCR（nested PCR）技术进行检测,并随机抽取Mpn和Cpn和3例套式PCR阳性产物进行全自动荧光DNA测序确诊。结果：肺炎儿童Mpn和Cpn套式PCR阳性检出率分别高达30.0%和35.0%,明显高于健康儿童的2.5%和2 .5%（P均＜0.01）,肺炎儿童中Mpn、Cpn双重阳性者为27例,达20.1%。结论：Mpn和Cpn是我国儿童肺炎的重要病原体,并存在较高比例的Mpn、Cpn双重感染者。     

生殖支原体及解脲脲原体对妊娠的影响研究

目的：进一步探讨生殖支原体（Mg)及解脲脲原体（Uu)对妊娠的影响。方法：应用灵敏、特异的套式PCR（nPCR）技术对219例胎盘组织进行Mg、Uu检测,并对Mg、Uu nPCR阳性产物各1例进行了DNA序列测定以验证。结果：早产、胎膜早破者的Mg、Uu,胎儿窘迫者的Mg之阳性检出率均明显高于正常妊娠者（P均小于0．01）;另外,上胎流产、死胎者和本次妊娠3．00以上,呈强关联。结论：Mg与Uu一样,围产期感染可致不良妊娠结局。     

早产儿咽部5种支原体感染状况调查研究

目的：探讨早产儿中解脲脲原体（Uu）、肺炎支原体（Mpn)、生殖支原体（Mg）、人型支原体（Mh)、发酵支原体（Mf)等5种支原体感染状况。方法：收集36例早产儿咽拭子标本应用nested PCR(nPCR）进行了Uu、Mpn、Mg、Mh、Mf等5种支原体检测。结果：36例早产儿中13例检出Uu(36.1%),5例检出Mpn(13.9%),2例检出Mg(5.6%)。Mh、Mf没有检出。结论：我国早产儿中至少存在有Uu、Mpn、Mg3种支原体感染。由于早产儿的肺炎、支气管发育不良、ARDS、脑室出血等并发症与支原体相关。我国早产儿者的高支原体感染状况应引起优生工作者的重视。     

发酵支原体感染与不良妊娠结局的研究

目的：探讨围产发酵支原体（Ｍｆ）的母婴传播状况及Ｍｆ 感染与不良妊娠结局的关系。方法：采用现阶段被认为是检测临床标本中支原体最灵敏最特异的方法套式聚合链反应（ｎＰＣＲ）技术。结果：５２ 例正常妊娠妇女母婴标本无１ 例检出ＭｆＤＮＡ,在６５ 例异常妊娠妇女中,有７ 例母婴标本检出ＭｆＤＮＡ,阳性率为１０－７％ （明显高于正常妊娠妇女Ｐ＜０－０１） 。其中宫颈脱落细胞、羊水、新生儿咽拭子标本均检测到阳性病例。７ 例ＭｆＤＮＡ 阳性者,均存在不良妊娠结局。结论：围产期存在Ｍｆ 感染,并可能是导致不良妊娠结局的原因之一。进一步深入研究是十分必要的。     

输卵管妊娠患者宫颈拭子解脲脲原体套式(Nested)PCR检测

近年来，有关解脲脲原体（ＵＵ）感染与盆腔炎症性疾病（ＰＩＤ）的关系报道较多。但生殖道ＵＵ感染与输卵管妊娠的关系研究报道甚少。为此，我们应用更为灵敏、特异的套式（Ｎｅｓｔｅｄ）ＰＣＲ技术检测了１７例输卵管妊娠患者的宫颈拭子ＵＵ－ＤＮＡ，并以同期５３６例非输卵管妊娠妇科住院病人宫颈拭子为对照组。检测结果为，前者阳性率为７６．５％，而后者仅为２１．４％，有显著性差异（Ｐ＜０．０５）。作者认为ＵＵ感染所致的输卵管急慢性炎症是输卵管妊娠的重要原因。作者建议：婚龄妇女应定期作ＵＵ生殖道感染检查，阳性者及时治疗，以防止ＰＩＤ和输卵管妊娠的发生。     

上呼吸道感染孕妇衣原体(Ct、C pn、C ps)感染研究

孕妇产前感染沙眼衣原体 (Ct)、肺炎衣原体 (Cpn)、鹦鹉热衣原体 (Cps)均可导致不良妊娠结局。为了解上呼吸道感染 (上感 )孕妇Ct、Cpn、Cps 3种衣原体感染状况 ,我们收集了 5 8例上感孕妇的咽拭子标本采用衣原体属特异套式PCR(nPCR)和Ct、Cpn、Cps 3种衣原体种特异nPCR进行了检测。结果 :衣原体阳性者 6例 (阳性率 10 .3% ) ,6例衣原体阳性者中 4例Cps阳性、1例Cpn阳性 ,另 1例分种鉴定为阴性。Cpn与CpsnPCR各 1例阳性产物经DNA序列测定与美国NCBI登录典型株序列一致。Cps为人兽共患病病原体 ,我国动物感染率较高。因而孕妇Cps感染值得优生科学工作者的关注。     

无锡地区2001年-2002年生殖道感染者4种支原体分子流行病学研究

目的了解无锡地区2001年-2002年男女性生殖道感染者解脲脲原体(Uu)、人型支原体(Mh)、生殖支原体(Mg)、肺炎支原体(Mpn)感染状况.方法收集2001年～2002年来无锡市第一人民医院就诊的1600例男女性生殖道感染者病灶部拭子标本(男:尿道拭子,女:阴道拭子),应用套叠式聚合酶链反应(nPCR)技术进行Uu、Mh、Mg和Mpn 4种支原体核酸检测.结果 1600例男女性生殖道感染者Uu、Mh、Mg和Mpn 4种支原体阳性率分别为42.3%、18.9%、5.0%和6.1%,支原体总阳性率达51.5%;其中女性Uu、Mh 2种支原体的检出率明显高于男性.结论无锡地区2001年-2002年男女性生殖道感染者中支原体感染率高,且已构成流行.     

新生儿和儿童肺炎支原体和衣原体检测研究

为了解新生儿和儿童肺炎者肺炎支原体（Mpn）、解脲脲原体（Uu)、肺炎衣原体（Cpn）、沙眼衣原体（Ct）等支原体、衣原体的感染状况,我们收集了29例足月新生儿肺炎者、24例早产新生儿肺炎者和41例儿童肺炎者的咽拭子标本,就用套式PCR（nPCR）技术进行了检测。结果发观新生儿肺炎者中存在Mpn、Uu、Cpn、Ct4种病原体感染者,阳性率在11．8％－62．2％之间,儿童肺炎者中存在Mpn、Cpn、Ct3种病原体感染者,阳性率分别为19．5％、22．0％、9．8％,无Uu感染者。Mpn、Cpn一直被认为是社区获得性肺炎（CAP）的病原体。本文从新生儿肺炎者的咽部查出Mpn、Cpn进一步支持Mpn、Cpn存在母婴传播之论点。     

不良妊娠结局孕妇人微小病毒B19感染与垂直传播的研究

目的 探讨武汉地区妊娠妇女人微小病毒B19的感染状况、临床表现及母婴垂直传播途径。方法 以不良妊娠结局孕妇作为病例组,以同期妊娠顺利孕妇作为对照。采用非结构蛋白DNA巢式PCR检测方法及传统的结构蛋白巢式PCR方法作为并联实验,检测孕妇血清及部分妊娠产物中的人微小病毒B19DNA。结果 不良妊娠结局孕妇血清标本中B19病毒DNA检出率为26．32％(20／76),对照组血清标本检出率为6．98％(12／172例),二者差异具有显著性。B19病毒感染孕妇常见的临床表现有：孕期反复出现“流感样症状”、“咽喉炎、少数孕妇的面部及躯体出现丘疹样红斑、关节痛。平素健康状况较差及贫血者更易感染。在部分自然流产的绒毛组织、死胎及畸胎的胎盘组织、胎儿组织中检测到B19病毒DNA。结论 武汉地区妊娠妇女存在人微小病毒B19的感染,并可通过胎盘传播给胎儿,导致不良妊娠结局。     

早产儿及低体重儿四种支原体感染状况研究

为了解早产儿、低体重儿人型支原体 (Mh)、解脲脲原体 (Uu)、生殖支原体 (Mg) ,发酵支原体 (Mf)等 4种支原体的感染状况 ,我们于 1997年～ 1998年分别收集了 2 7例早产儿和 2 1例低体重儿的咽拭子标本应用套式PCR (nPCR)法进行上述 4种支原体特异性核酸检测。结果早产儿和低体重儿的Mh阳性率分别为 92 6 %、95 2 % ;Uu阳性率分别为 5 5 5 %、38 1%。Mh Uu合并感染状况严重 ,分别为 5 5 5 %、33 3%。Mg只有 1例阳性 ,Mf无阳性病例发现。无论是早产儿 ,还是低体重儿 ,剖宫产与阴道产的各种支原体检出率无差别 (P均 <0 0 5 )。剖宫产娩出儿咽部查出支原体可确认为宫内感染 ,由此可见 ,支原体宫内感染状况严重。本文并就支原体感染与早产和新生儿出生低体重的发生原因进行了讨论。     

Vaginal colonization by genital mycoplasmas in pregnant and non-pregnant women

To compare vaginal colonization by genital micoplasmas in pregnant and non pregnant women and to determine the association between pregnancy and colonization by these microorganisms, samples of exocervix an endocervix from pregnant (n = 80) and non pregnant (n = 65) women, from two health centers of Maracaibo, Zulia State, Venezuela were processed. The Mycoplasma-Lyo kit (bioMérieux laboratories) was used for the culture and identification of genital micoplasmas. In pregnant women, prevalences of 10% for M. hominis and 26.25% for Ureaplasma spp. were found; 35.38% for M. hominis and 20% for Ureaplasma spp. in non-pregnant, were obtained. Among the pregnant, Ureaplasma spp. was the most frequently isolated micoplasma, in symptomatic and asymptomatic; while in the non pregnant group, M. hominis was more common among the symptomatic patients; only one case (1.54%) was an asymptomatic carrier of Ureaplasma spp. The highest positivity percentages were obtained in primigravidas (48.71%) and during the second gestational trimester (34.21%). No statistically significant differences were found between vaginal colonization by genital micoplasmas according to age, number of pregnancy and gestational trimester; but they were found between the presented symptomatology and vaginal colonization by genital micoplasmas. Genital micoplasmas were isolated from gravid women at approximately the same recovery rate as in non-pregnant women; being M. hominis the most frequently isolated in non-pregnant women and Ureaplasma spp. in the pregnant group.     

Reactivation of human herpesvirus 6 and 7 in pregnant women

To elucidate the roles of human herpesvirus (HHV)-6 and -7 in pregnant women, peripheral blood samples and genital tract secretions were collected serially from pregnant women, and both serological testing and polymerase chain reaction (PCR) were carried out to detect viral DNA in the secretions. HHV-6 or HHV-7 Immunoglobulin(Ig)M antibodies were not detected in 432 plasma samples collected from pregnant women and cord blood, but IgG antibodies against both viruses were detected in all plasma samples. Significant increases in HHV-6 and HHV-7 IgG antibodies were observed in two (1.6%) and three (2.4%) pregnant women respectively of a total of 123 cases. HHV-6 DNA was detected in the genital tract in three (3.7%) of 82 pregnant women at the first trimester, and in 10 (12.2%) of the same women in the third trimester. The detection rate in the third trimester was significantly higher than that in the first trimester (P = 0.043). Although HHV-7 DNA was detected in the genital tract of two (2.7%) and seven (9.6%) pregnant women of a total of 73 during the first and third trimesters respectively, there was no statistical difference in the detection rate of the viral DNA between the trimesters. Because a significant increase in HHV-6 IgG antibodies was detected in only two pregnant women, it was not possible to carry out statistical analysis to determine the relationship between HHV-6 infection and associated clinical features. Although there was a significant increase in HHV-7 antibody titers in three pregnant women, a positive correlation between the virus infection and the clinical features was not demonstrated. There was no statistical association between virus shedding in the genital tract and the clinical features examined in this study.     

Prevalence and genotype distribution of cervical human papillomavirus infection: Comparison between pregnant women and non-pregnant controls

Controversies exist on the effect of pregnancy on human papillomavirus (HPV) infection. A cross-sectional section study was conducted to compare the prevalence and genotype distribution of cervical HPV infection between pregnant and non-pregnant women in Hong Kong. Cervical samples were collected from 308 pregnant women and from the same number of age-matched controls recruited from a cervical cancer screening center located at the same hospital. HPV was detected by the polymerase chain reaction, followed by genotype identification by restriction fragment length polymorphism and direct sequencing analyses. The prevalence of HPV for pregnant women was 10.1%, without significant variation with age, gestation, gravidity and parity. The prevalence of HPV for non-pregnant group was 11.4% and did not show significant difference when compared to the pregnant group either by overall or age-stratified subgroup analyses. When the analysis was stratified according to the risk-type of HPV infection, still no significant difference between pregnant and non-pregnant groups was observed (all types: 10.1 vs. 11.4%, P = 0.602; high-risk types: 5.8 vs. 7.8%, P = 0.338; low-risk types: 1.0 vs. 2.9%, P = 0.080; unknown-risk types: 3.2% vs. 1.3%, P = 0.105). The results of this study show no evidence for an influence of pregnancy on HPV prevalence, and a majority of HPV-infected pregnant women had normal cervical cytology. HPV positive results in pregnant women per se should be managed conservatively.     

Escherichia coli bacteraemia in pregnant women is life-threatening for foetuses

In order to improve knowledge on Escherichia coli bacteraemia during pregnancy, we studied clinical data and performed molecular characterization of strains for 29 E. coli bacteraemia occurring in pregnant women. Bacteraemia mostly occurred in the third trimester of pregnancy (45%) and was community-acquired (79%). Portals of entry were urinary (55%) and genital (45%). E. coli strains belonged mainly to phylogroups B2 (72%) and D (17%). Four clonal lineages (i.e. sequence type complex (STc) 73, STc95, STc12 and STc69) represented 65% of the strains. The strains exhibited a high number of virulence factor coding genes (10 (3–16)). Six foetuses died (27%), five of them due to bacteraemia of genital origin (83%). Foetal deaths occurred despite adequate antibiotic regimens. Strains associated with foetal mortality had fewer virulence factors (8 (6–10)) than strains involved in no foetal mortality (11 (4–12)) (p 0.02). When comparing E. coli strains involved in bacteraemia with a urinary portal of entry in non-immunocompromised pregnant vs. non-immunocompromised non-pregnant women from the COLIBAFI study, there was no significant difference of phylogroups and virulence factor coding genes. These results show that E. coli bacteraemia in pregnant women involve few highly virulent clones but that severity, represented by foetal death, is mainly related to bacteraemia of genital origin.     

Epidemiology of human papillomavirus genotypes in pregnant Japanese women

To investigate the pre-vaccination epidemiology of genital human papillomavirus (HPV) infections and genotypes in pregnant Japanese women, we performed Pap smear tests and HPV genotype testing in patients attending Nagasaki University Hospital and collaborating hospitals from August 2007 to July 2010. Serial uterine cervical specimens were obtained from 151 pregnant women. The HPV test was positive on the first visit in 54 women (35.8%; 54/151, average age 30). A total of 49 women (32.5%; 49/151) were infected by at least one high-risk HPV and 5 women were infected by only low-risk HPV. The three most prevalent high-risk HPV genotypes were HPV 52 (31.5%; 17/54), HPV 16 (29.6%; 16/51) and HPV 31 (13.0%; 7/51). The HPV infection pattern (negative, single infection and multiple infection) differed significantly according to the pregnancy trimester (χ(2)-test; P<0.01(Pearson)). Among HPV-infected pregnant Japanese women, HPV52 was the most common genotype. The second most common genotype was HPV16, and these two genotypes accounted for ～60% of HPV-positive pregnant women. Infection with multiple HPV genotypes was observed more frequently in the first trimester of pregnancy and the pattern of infection changed significantly depending on pregnancy stage.     

Screening for vaginal shedding of cytomegalovirus in healthy pregnant women using real-time PCR: correlation of CMV in the vagina and adverse outcome of pregnancy

The impact of cytomegalovirus (CMV) infection of the genital tract during pregnancy on adverse pregnancy outcomes is not understood fully. A real-time PCR assay was used to determine vaginal shedding of CMV in 993 healthy pregnant Japanese women and the results were compared with the outcome of pregnancy. CMV DNA was detected in 76 (7.7%) of the women. The outcome of pregnancy could be determined finally in 848 women, of whom 60 (7.1%) were CMV positive. The carriers of CMV had an increased miscarriage rate (RR 6.96, 95% CI 2.04-23.84, P < 0.01). These findings suggest that latent genital tract CMV infection predisposes to adverse pregnancy outcomes.     

Endometriosis in pregnant and non-pregnant women at tubal sterilization

The prevalence of endometriosis was investigated in 208 women at the time of laparoscopic tubal sterilization. In 101 women who were in the first trimester of pregnancy, 16% endometriosis was found. In 107 non-pregnant women, 22% endometriosis was detected. Endometriosis in the pregnant women showed more superficial, non-pigmented, gland-like lesions than in the non-pregnant group. In 23% of the endometriotic lesions from pregnant women, no decidualization was found. No special risk factors for developing endometriosis were found.     

孕妇巨细胞病毒感染对胎儿影响的前瞻性研究

用酶联免疫吸附试验（ＥＬＩＳＡ）及聚合酶链反应（ＰＣＲ）方法对沈阳市４５０名孕妇进行巨细胞病毒（ＣＭＶ）筛查，并前瞻性追查到其婴儿１００名ＣＭＶ感染状况。结果孕妇９７．１１％为既往感染，０．８９％为原发感染，１１．１１％为复发感染，仅２％为易感者。４５０例中感染组孕妇有畸形儿３例，流产３例，其胎儿感染率与致畸率明显高于对照组。１００例母婴检查结果：感染组孕妇所生先天性感染儿比对照组多１．４３倍（ＲＲ＝１．４３），感染组有２名低智儿，对照组无。本组早孕原发感染对胎儿危害最大，其宫内传播率为３３．３％。感染组孕妇９例感染儿中２例巨细胞包涵体病，７例无症状。为了早期诊断达到优生目的，对孕妇进行ＣＭＶ筛查是必要的，但筛查过程中发现有活动感染时处理要慎重，最好追查到羊水阳性时考虑终止妊娠。